Driving the change within AstraZeneca: building a coalition

AstraZeneca

Diversity in science is not just about the workforce it is also about the underlying research itself.

Within the workforce, addressing diversity is critical for productivity of our staff. Within our research practice, ensuring our research represents our patient population is critical for the productivity of our drug discovery and development pipeline to deliver the right safety and select the right patient population.  Our community is ready to engage but these issues are not issues for an individual alone to solve.  Our institutions need to build coalitions to drive change and to challenge the biased beliefs and practices to enable change to occur.

AstraZeneca is a science led global pharmaceutical company with a vision to deliver life-changing medicines.  Five employees of AstraZeneca attended the 2019 EDIS symposium; where four were audience participants and one had a role as a presenter at the meeting. The attendees spanned different functions, areas of the organisation, and career levels at AstraZeneca. Here we explore our reflections and resulting commitments from the symposium with a common focus on ensuring AstraZeneca research follows the science and delivers to our patients.

What particularly resonated?

Our early career scientist, Hannah Moore, found the day eye-opening and consequently fascinating as it challenged her inherent subconsciously biased beliefs. Hannah was particularly struck by the efforts to ensure that the event itself was inclusive, diverse and accessible for all.  The meeting demonstrated in practice what being inclusive meant in reality and the breadth of changes that are needed to our standard working practices. Examples of practice included: articulating to all the code of conduct and inclusion statement of appropriate engagement, giving the opportunity to choose a pronoun and hence normalising the conversation around selecting the appropriate pronoun and the use of silent clapping to ensure that people with hearing difficulties were not overwhelmed by the noise level. These practices, though different, were not onerous nor did they prevent an effective meeting where ideas were shared.  Within AstraZeneca, as part of talent development, Hannah leads an employee resource group to influence the new generation of scientists, and now these strategies will be implemented to become our norm and ensure our symposiums are just as inclusive.

Zara Ghazoui, a data scientist who focuses on the analysis of genomic data and clinical data within AstraZeneca to identify novel therapeutic targets and enable patient selection for precision medicine, was fascinated by the discussions around meta research.  This is research into the research process itself to ensure that inclusion and diversity is embedded in the foundation of scientific research including funding, research content, publications and authorship.   She was very interested to hear the examples from other pharmaceuticals companies that have benefitted hugely from data on genetic diversity illustrating the immense need to include both sexes as well ethnic diversity for successful clinical trials and drug development programs.  These ideas resonated strongly with her work in human genetics, as it is essential that one generates data from diverse populations for any scientific research and even more so in the era of precision medicine. Given the huge genetic diversity in Africa, she was very excited to learn about some of the current efforts that Wellcome Trust is making in Africa to investigate genetic diversity in human genomes, which would enable us to truly benefit patients across the globe.

For Toyin Kasali, the area of diversity in clinical trials and the use of AI in clinical trials was particularly interesting. As a project manager who works on delivering AstraZeneca’s drug development programs, she was particularly stunned to hear about some of the barriers that prevent diverse groups from participating in clinical trials. From a project management perspective, we know how important it is to design our clinical trials robustly and from an AZ perspective, one of our core values is to focus on our patients. As a result, it was important to hear about some of the recommendations and solutions presented to encourage participation from more diverse backgrounds. The speakers highlighted that within the artificial intelligence field, researchers are developing smarter in-silico tools that can aid the interrogation of heterogenous data sets and provide more nuanced conclusions. Examples of how other pharmaceutical companies have benefitted from having greater diversity illustrated the need to include sex as well as ethnic diversity for successful clinical trials and drug development programs.

How do we move forward?

During the EDIS meeting, Dr Natasha Karp presented a recently published article reviewing the prevalence of sex bias in the preclinical experimental space and the drivers leading to studies predominately including only one sex of animals [1]. The article highlighted that sex bias was endemic in practice and embedded in our research practice. Through exploration of various change management theories, significant leadership is needed to drive change (Figure 1).  The theories highlight how the early steps for change need to focus on winning the hearts and minds of the community through leadership with a focus on generating and sharing a vision.  Only then can we start to explore the obstacles and construct solutions which we can then embed in our research culture, where it becomes the norm and an unspoken belief of standard practice.

Fig 1: Adaptation of Schein’s model of Organisational Culture [2] relative to Kotter’s eight step approach [3].

Combining these models formed our framework for change to shape a strategy that will lead to mindset change on the need to address sex bias in our preclinical research.

Following the EDIS meeting, we have assembled a coalition across the company working together with a vision to remove the cultural barriers that maintain the sex bias in our practices.  As with many organisations, awareness of the embedded sex bias was low. This group has had significant success in raising awareness of the prevalence of sex bias and the resulting risk to patient outcome, demonstrating the receptiveness of the scientific community.  For example, 1400 people dialled into a presentation exploring the topic across the company. Through education and consultation, we have started making incremental steps towards better practice.  For example, in the in-vitro space where cell cultures are used to explore the science of interest, many scientists had not realised that cells could be considered to have a sex and this could impact scientific outcomes.  We have added training material for our scientists and nudge questions when material is being ordered to encourage greater awareness of the sex of the samples being used.

The future?

AstraZeneca prides itself on having embedded values that influence and drive our behaviour across the company.  These values include behaviours to ensure we follow the science, act with integrity and leverage diversity. Through embracing these we will be a successful, sustainable company. EDIS demonstrating what inclusivity in a meeting should look like is critical step on the path of these approaches becoming the norm within our organisations.

It is also critical for our company to embrace diversity in our underlying research and therefore we need to embrace sex as a biological variable in our experiments to ensure our products have the right safety and deliver the efficacy needed for our patient population. Sex bias is an embedded research practice and is not a problem for individual scientists to solve in isolation.  We have started the journey of building coalitions to enable our scientists to become agents for change, which requires the sponsorship and endorsement of our leaders. This collective approach is necessary to move forward and allow the community to step up to the challenge and start the journey.

 

[1]. Karp, N. A. & Reavey, N. Sex bias in preclinical research and an exploration of how to change the status quo. British journal of pharmacology (2018).

[2]. Schein, E. H. Organizational culture and leadership. Vol. 2 (John Wiley & Sons, 2010).

[3]. Kotter, J. P. Leading change.  (Harvard business press, 2012).

Dr Natasha A. Karp is a Principal Biostatistician with AstraZeneca with fifteen years’ applied statistics experience arising from both commercial and academia settings, including the Wellcome Sanger Institute and the University of Cambridge. Dr Karp’s research interest has focused on improving replicability, reproducibility and generalisability of studies. Recently, Dr Karp has focused on the potential of change management theories to help the scientific community improve the quality of our science

Hannah Moore graduated from the University of Leeds with a Master’s in chemistry, soon after she joined AstraZeneca’s Research and Development programme. Hannah has had placements in genetic toxicology, metabolism of potential treatments and quantitative system toxicology. Hannah is passionate about creating an inclusive and diverse environment in the workplace.

Toyin Kasali is an Associate Project Manager with AstraZeneca and has several years’ experience in biotherapeutics and small molecule drug development and project management. Toyin is passionate about providing the right information for colleagues to be empowered and to reach their full potential.

Penny James is Chief Operating Officer, BioPharmaceuticals R&D, AstraZeneca. Penny is a Chartered Statistician who has worked for AstraZeneca for 11 years and has over 25 years’ experience working in the pharmaceuticals and chemicals industries in a variety of consulting and leadership roles. Penny is the AZ senior leadership representative member of EDIS.

Dr Zara Ghazoui is a genome analyst at AstraZeneca with 15 years of bioinformatics from both industry and academia. Dr Ghazoui’s work focusses on the discovery of new targets for cancer therapies to help us improve and potentially save patients’ lives. Dr Ghazoui comes from a diverse background at both professional and personal levels and is passionate about making a change towards a truly diverse and inclusive environment.

Neil Reavey is Associate Director of Research Assurance at AstraZeneca, and has worked in drug discovery for over 20 years. Neil holds an MSc in Organisational Psychology and is a leader in Inclusion & Diversity, with the role of External Insights Lead on AstraZeneca’s Global Inclusion and Diversity Council. His voluntary roles include Co-chair of the Proud Science Alliance and Trustee of Cambridge LGBT youth charity, The Kite Trust.